Despite increasing establishment of total arterial revascularization of the myocardium, the great saphenous vein remains an essential component of coronary bypass surgery. Until recently, the conventional technique of open vein harvesting (OVH) and its advancement, the so-called bridge technology, were standard techniques in bypass surgery. In appreciation of minimally invasive surgery, the endoscopic vein harvesting (EVH) was developed. Especially in consideration of cosmetic results and patient contentment but also within regard to frequency and severity of postsurgical wound complication and infection, EVH presents an appealing alternative to extraction of graft material for myocardial revascularization. Controversy on quality and long-term patency of EVH graft material continues. However, recent trials were not able to show a significant difference with regard to patient outcome and bypass patency. Therefore, the EVH technique is currently considered to be a safe alternative to conventional OVH. However, in light of today’s heterogeneous data situation, further scientific studies are required in order to meet criteria for evidence-based medicine in this field.